I'm just a veterinarian! You've unlocked the Great Physician System!

A call to action for multidisciplinary team collaboration was issued.

The anesthesiology department received notification to prepare for general anesthesia.

The neonatal ward was also informed that there was a high-risk infant who might be suffering from severe asphyxia and would require intubation, necessitating the arrival of the best neonatal resuscitation team!
Although Dr. Ogawa's resuscitation skills are top-notch, he had already performed high-intensity resuscitation on a mother and child during the day, and even underwent two surgeries. Now, Dr. Ogawa's physical strength is unknown, so no one knows if he has the energy to continue resuscitation.

Even if there is still some left, it is probably at its last gasp.

A neonatal resuscitation team is indispensable in such situations.

The blood transfusion department, which is of course the most critical, also received a request for support, requiring that red blood cells, plasma, and platelets arrive within 15 minutes!
This is a nightmare in obstetrics: severe placental abruption. You can't wait for the results to come out before applying, otherwise the person will be gone before the blood even arrives.

The operating room nurses were also quickly preparing large-sized indwelling needles, two 18G or larger catheters, a central venous catheter kit, an autologous blood transfusion machine, B-lynch sutures for hemostasis, and uterine packing balloons...

"Family, the patient's condition is deteriorating. We will do our best to save the mother and the child. It may require a hysterectomy to stop the bleeding and a large blood transfusion. These are the consent forms. We hope you can fully understand and trust us so that we can perform the surgery without worry."

Zhao Lingyun is in charge of communicating with the family, while Zhang Lingchuan has gone to disinfect himself and prepare to enter the operating room.

To increase the success rate, he also needed to learn about the patient, Li Xiaoxiao, in advance.

"Dr. Zhao Lingyun, we trust Veterinarian Zhang!"

Unlike before, Ding Zhenyu and Zhou Liqiong's family members did not make a fuss or show any misunderstanding. Instead, they simply picked up a pen and signed the document.

As family members, we certainly know what this signature means; it means that our wife's life is now entirely in the hands of these doctors.

Even if the rescue fails, there will be no way to save him.

But now that things have come to this, what else can we do but trust Dr. Zhang?

"Signed!"

Soon after, the family members signed the papers, and Zhao Lingyun carefully checked them to confirm that everything was correct.

"Don't worry, we will do our best. In addition, Dr. Li Tinglan, the director of the Department of Obstetrics and Gynecology, and Dr. Zhao Wan are on their way."

Zhao Lingyun said earnestly.

This also puts the patient's mind at ease.

This is almost the highest configuration available at the First Affiliated Hospital of Jilin University, and even in the entire Chunshi area.

"Professor Li Tinglan is here too! Okay! Okay! I'll have to trouble you! If possible, save both the adults and the children. If you really have to choose, save the adults!"

Ding Zhenyu met Zhao Lingyun's gaze, his eyes filled with unprecedented joy and determination.

They had originally intended to register with Professor Li and have their medical records established with him.

After all, she is the director of the obstetrics and gynecology department and a level-two expert.

Unfortunately, the other party's number was too sought after, so they ended up calling Director Zhao Wan.

He is, after all, a chief physician and a level four expert.

Their abilities are certainly not weak.

Now that he heard that both of them had come, Ding Zhenyu felt that his wife's chances were much better.

As for the question about adults and children.

He felt there was no need to choose at all.

Without adults, there would be no children.

Moreover, his emotional foundation is all built with adults.

If there is really no choice and only one child is left, then there is nothing that can be done. If there is even the slightest choice, he will choose the adult.

"What a good husband!"

"Oh my god, I so wish my husband would say 'Save the mother' without hesitation when I give birth!"

"Actually, it's normal to save the mother's life. Many families are abnormal; they let the adults die in order to save the child."

"Sigh... I never imagined that Veterinarian Zhang wouldn't go to eat for this reason. Is severe placental abruption really that dangerous?!"

"Just Google it, buddy. Severe placental abruption is known as the 'Obstetric Death' or 'Obstetric Nightmare,' and I'm not kidding."

"Being a doctor is never easy, which is why many doctors suffer from stomach problems. Look, I was just about to go eat when a patient came in, and it was such a dangerous situation. You can't refuse to take the job."

……

Studio.

[Number of viewers watching the provincial TV station's "Medical Path to Success" live stream: 12290801.]

After the camera cut to the hospital, the number of viewers had reached over 12 million.

The footage shows Zhao Lingyun talking to her family.

The key people are all blurred out, but everyone knows what happened.

They were all immediately filled with emotion.

Similarly, some of my fellow doctors looked helpless.

They can't even cook properly.

I have to come back if something happens.

Especially in a critical situation like this, even if you are the director, you don't have any special privileges.

You should come back.

Because if something happens to a person, a pregnant woman, being the highest-level patient, is more dangerous than a bomb.

Therefore, the doctors also hope to do everything they can to save the person.

If they are saved, it will be a major achievement for the department and even the hospital when the news report is published.

It's a win-win situation.

Who doesn't like a win-win situation?
"Mr. Ding, current laws stipulate that no matter what happens, the priority is to save the adult. Don't worry!"

Zhao Lingyun left with the signed documents.

In the operating room.

Now that the family has given their absolute trust and authorization to carry out the entire surgery, Zhang Lingchuan came to Li Xiaoxiao's side.

She had already fainted, and the anesthesiologist was administering anesthesia.

The person sent was the deputy director of the anesthesiology department, Teacher Ma.

Yes, the head of the anesthesiology department's surname is Ma.

Hearing this surname and this profession for the first time, many people feel that Teacher Ma was born to administer anesthesia.

Teacher Ma's full name is Ma Lin.

The chosen method of anesthesia was general anesthesia.

Because placental abruption is often accompanied by shock and coagulation disorders, general anesthesia has a rapid onset, can quickly control the airway, prevent aspiration, and facilitates muscle relaxation management if a hysterectomy is subsequently required.

Besides anesthesia.

The position of the mother during childbirth is also very important. Zhang Lingchuan directly chose to make a 30-degree oblique incision on the left side and raise the lower limbs. This can reduce the pressure of the uterus on the inferior vena cava and ensure the amount of blood returning to the heart.

"We're getting ready for surgery. Have the chief surgeon and the others arrived yet?"

Zhang Lingchuan inquired.

[The patient is currently experiencing severe placental abruption, the fetus is asphyxiated and near death, and the mother is unconscious. As the attending physician, you possess master-level cesarean section skills. Please perform an emergency cesarean section as quickly as possible. Success rate is over 95% if completed within 5 minutes; 50-95% within 10 minutes, but the newborn may not survive; after 10 minutes, the survival rate drops drastically to 20%; after 15 minutes, it's 1%... A reward will be given based on the degree of completion upon completion!]

This is his second scan.

According to the scan of Li Xiaoxiao, a pregnant woman with severe placental abruption, the procedure can be completed within five minutes, with a success rate of over 95%.

But this is something only a master-level technique can achieve.

There was only one associate chief physician among the doctors on duty at the scene.

Zhang Lingchuan checked the other party's skill points with his eyes, which he could look at once every day; the uterine dissection technique had barely reached the expert level.

So he wanted to ask Lan Jie and the others where they were.

If it takes more than five minutes.

He had to do it himself.

"Dr. Xiaochuan, Director Li and the others have arrived."

It's a seven or eight-minute walk, or a taxi ride directly to the hospital entrance, which of course only takes a minute or two.

In addition, the operating room is on the third floor.

Li Tinglan and Zhao Wan arrived in just four minutes, so they were already there. However, they needed to be fully disinfected and put on sterile gowns before entering the operating room, which slowed them down a bit.

"That's good, there's still time."

Zhang Lingchuan breathed a sigh of relief when he heard that the people had arrived.

At the same time, I started to mentally rehearse the surgery.

This is not a system-wide assessment; he only has one chance.

If you can't try again after failing, then he can't fail.

A normal cesarean section involves a horizontal incision, which is considered more aesthetically pleasing.

But at this moment, Zhang Lingchuan felt that he should make a longitudinal incision in the middle of the lower abdomen.

While transverse incisions are aesthetically pleasing, they offer limited exposure and are difficult to extend. Longitudinal incisions, on the other hand, allow for the fastest access to the abdominal cavity and delivery of the fetus, and provide greater operational space when it is necessary to explore the abdominal cavity or remove the uterus.

As for entering the stomach.

This goes without saying.

The movements must be quick! And you must also avoid damaging the bladder, which may shift due to uterine contraction and hardening!
It's a technical job.

If he had the time, Zhang Lingchuan even considered simulating the system space.

Normally, one minute is enough.

But now, as long as the timing is managed properly, the success rate is over 95%.

[Special Items: Special Stamina Potion *34, System Simulation Space Single Training Card *2, Precision Detection *5, Hidden Item Card Fragment *2.]

He now has two special item cards.

Take ten thousand steps back.

Even if something goes wrong during the process, you can still use the process as a basis for steering training.

All you need to do is give him thirty seconds to do it.

Because the length of a single training card in the system space can be increased or the training time can be shortened.

"Xiao Chuan, you're really something! You shielded Teacher Zhao from a huge disaster! You know the ropes better than any of us now, so we'll be your first and second assistants! If you encounter anything you can't handle, we'll help you with that too!"

Less than a minute after he finished speaking, Li Tinglan and Zhao Wan arrived.

The two were fully armed.

After Li Tinglan arrived, she said something.

It really saved Teacher Zhao from a major disaster.

After all, the file was created with her.

If something really goes wrong, she, as the doctor who has been with the patient since the third month of her pregnancy, will have a relationship that is difficult to clear.

Fortunately, Xiao Chuan was there all along and had a better understanding of the patient's condition.

She also watched Ali's surgery.

Ogawa has extensive experience in cesarean section surgery, even more so than the average person.

So she wanted to see if Xiaochuan had any insights into this surgery, and whether there was a pre-prepared surgical plan.

If it's already done, then let him try it out.

If any problems arise during the surgery, she and Dr. Zhao can help.

"A midline longitudinal incision in the lower abdomen."

The scrub nurse was already prepared.

Zhang Lingchuan swiftly made his cut.

Li Tinglan and Zhao Wan nodded in agreement upon hearing Zhang Lingchuan's words.

Normally, a transverse incision is made in the lower segment of the uterus for uterine incision. If the fetal distress is severe, a longitudinal incision in the body of the uterus can be made. Although there are more complications, it can save lives.

The uterus was quickly cut open.

Zhang Lingchuan did not wait for natural delivery, but immediately removed the fetus by hand.

"The baby's head is high up, so I'm applying pressure to the fundus."

Director Zhao Wan joined in, while Zhang Lingchuan was responsible for traction. After they came out, the umbilical cord was quickly cut and they were handed over to the neonatal department for emergency treatment.

"Evaluate!"

Luo Feng, deputy director of the neonatal department, is conducting an Apgar score assessment.

Apgar is an acronym for five English words: appearance, pulse, grimace, activity, and respiration.

First developed by Dr. Virginia Apgar in 1952, the method is a rapid assessment of neonatal asphyxia and its severity. It is based on five signs within one minute after birth: heart rate, respiration, muscle tone, laryngeal reflex, and skin color. Each sign is scored from 0 to 2 points, with a maximum score of 10 points.

Generally speaking, the higher the score, the more normal the child is, and vice versa.

"Skin color".

The neonatal team is conducting an assessment.

A score of 2 is given for pink skin all over the body, 1 for pink torso and bluish-purple limbs, and 0 for bluish-purple or pale skin all over the body.

"His entire body was purplish-blue."

The doctor in charge of the examination answered.

"0 points."

Luo Feng's heart sank.

"What about heart rate?"

Under normal circumstances, a newborn's heart rate is 2 points if it is greater than 100 beats per minute, 1 point if it is less than 100 beats per minute, and 0 points if there is no heart rate.

"No heart rate."

The doctor in charge of the examination answered again.

"Another 0 points!"

Luo Feng's expression became more serious than ever before.

"I will respond to the stimulus."

Luo Feng flicked the baby's soles with his hand, but there was no reaction.

At this moment, the baby also has a nasal tube inserted. Under normal circumstances, the baby will cry, sneeze or cough. At this time, you can get 2 points. If there is only a slight reaction such as frowning, you get 1 point. If there is no reaction at all, you get 0 points.

"Director, another zero!"

no doubt.

There was still no response this time.

Dr. Ogawa delivered the baby via cesarean section very quickly.

It only takes about three to five minutes.

But the situation is still bad.

"Another zero, this is troublesome!"

The fourth test is breathing.

Even breathing and a loud cry score 2; slow and irregular breathing or a weak cry score 1; no breathing score 0.

Clearly, he wasn't breathing either.

That means that out of the five tests so far, four have been scored as zero.

Follow the rules.

A score of 8-10 indicates a normal newborn.

A score of 4 to 7 indicates mild asphyxia, which requires measures such as clearing the airway, artificial respiration, oxygen administration, and medication to recover.

A score of 0-3 indicates severe hypoxia, which is considered severe asphyxia and requires emergency resuscitation. This involves endotracheal intubation under direct vision and oxygen administration.

This falls into the category of severe asphyxiation.

The last item is the muscle tone of the limbs. If the limbs are active, it is 2 points; if the limbs are slightly flexed, it is 1 point; and if the limbs are relaxed, it is 0 points.

"Director... all five items, zero points."

Within seconds, the neonatal team quickly made an assessment and immediately began resuscitation procedures such as endotracheal intubation and chest compressions.

Zhang Lingchuan also saw the red flashing tag above the child's head, but he couldn't get away right now.

Because the child's mother is also in critical condition.

After the placenta was removed, the uterus showed purplish-blue ecchymosis, which indicates uterine infarction and very heavy bleeding.

Oxytocin!

Zhao Wan shouted, and the IV drip was administered directly into the uterus.

Zhang Lingchuan and Li Tinglan were trying to stop the bleeding, as the bleeding was very heavy. Li Tinglan was performing B-Lynch sutures, also known as sling sutures.

This suture method has a very obvious hemostatic effect and is easy to operate.

Specifically, by mechanically compressing the uterine muscle layer longitudinally, reducing the pressure in the pelvic arteries, and compressing the blood vessels in the uterine wall to promote thrombus formation, the bleeding is stopped quickly and effectively.

It is especially suitable for refractory postpartum hemorrhage caused by uterine atony, with a high success rate in stopping bleeding.

In addition, the other party has the ability to preserve the uterus, effectively maintaining the integrity of the uterus and avoiding hysterectomy.

It helps protect the patient's fertility and endocrine function.

have to say.

As expected of Sister Lan at her peak, the suspender stitching is done exceptionally well.

"Ogawa, ligate the ascending branch of the uterine artery."

But there was still bleeding.

In the normal procedure.

If the suturing with a back strap cannot stop the bleeding, either the uterus must be removed, or the ascending branch of the uterine artery or the internal iliac artery must be ligated.

Compared to a complete hysterectomy, ligation of the ascending branch of the uterine artery or the internal iliac artery may allow for future pregnancy depending on recovery.

So it can be considered as giving pregnant women a chance to get pregnant.

"clear."

Zhang Lingchuan quickly underwent tubal ligation.

His masterful skills allowed him to handle the game with ease.

Of course, I don't mean any arrogance, because if I can't stop the bleeding at this stage, I'll have to have my uterus removed.

This is undoubtedly very cruel for a girl who is only twenty-three years old.

Therefore, he remained very cautious.

Fortunately, with the combined efforts of the two, they successfully stopped the bleeding in the mother and started resuscitation with only a few seconds left on the countdown.

The effect is remarkable.

On the newborn side, I must say the team was also very effective, continuously working on resuscitation.

After finishing his work here, Zhang Lingchuan went to provide support over there.

"sky--"

"Dr. Ogawa's resuscitation was absolutely amazing!"

All the medical staff at the scene widened their eyes, then breathed a sigh of relief.

Because the newborn finally resumed its faint breathing.

"A ventilator, quick, quick, quick!"

Luo Feng immediately arranged for a ventilator to be put on.

This child, who scored 0 points and whose umbilical artery blood gas analysis showed a pH value of only 6.68, was on the verge of death. At this moment, they finally saw a glimmer of hope.

However, this is only a tiny glimmer of hope, as complications such as hypoxic-ischemic encephalopathy still need to be addressed.

There are also relevant treatment methods available now, namely whole-body hypothermia therapy.

"Drip-drip-"

Blood pressure: 110/70 mmHg

[HR: 95 bpm]

SpO: 98%

GCS: 15

……

"call--."

At the scene, the instruments were beeping. After a period of hurried rescue, the mother's vital signs had temporarily stabilized. Meanwhile, the nurses and Deputy Director Luo Feng were busy dealing with the fetus, which had been re-evaluated. The fetus had now been re-evaluated and scored 5 points, a huge improvement from the previous critical 0 points.

So the atmosphere seemed unusually relaxed.

"Thank you all so much for your cooperation. We have created another miracle. We will release a press release about today's events. Everyone is a hero!"

Li Tinglan expressed her gratitude to everyone present.

Of course, the biggest incentive is to get everyone in the press release.

Of course, no one took credit for it. Instead, they said that it was thanks to Director Li, Dr. Xiao Chuan, and Teacher Zhao Wan that they were able to witness a placental abruption surgery that was of great educational value.

"Xiao Chuan, you must be starving. Now we can go eat."

More than forty minutes have passed, and it is now nine o'clock.

The food at the restaurant was definitely cold, but it didn't matter. She was happy because she had saved two more people!
It's fine to have another meal with Dr. Zhao and the others.

"strangeness."

However, Zhang Lingchuan stopped in his tracks as he was about to leave.

He noticed that the new mother had a red label on her head.

A normal red label is nothing to worry about, after all, there is an infection period after this kind of surgery, and you are truly safe once you get through it.

Therefore, some people will turn into yellow labels after surgery, while others will only turn into yellow labels after they have passed the infection period.

I've never seen anything like it before; after the surgery, besides the red tag, there was also a tag that said "Exploreable +500" on the top of the head.

Most importantly, this time it's no less than 500 professional reputation!
...(End of chapter)